Clinical nurses in Magnet hospitals confirm productive, healthy unit work environments

kramer m., maguire p. & brewer b.b . (2011) Journal of Nursing Management 19, 5–17
Clinical nurses in Magnet hospitals confirm productive, healthy unit work environments Aim To describe extent to which experienced nurses in Magnet hospitals confirm healthy work environments (HWE). Background Differentiating differences in HWE allows managers to focus attention where changes may be needed to improve nurse and patient outcomes. Method The sample was 12 233 experienced nurses from 717 clinical units in 34 Magnet hospitals. Based on Essentials of Magnetism II unit level scores, units were grouped as very healthy work environments (VHWE), HWE or work environments needing improvement. Results VHWE or HWE was confirmed by nurses on 82% of 540 clinical units. The most significant correlates of HWE units occur within individual hospitals. More nurses prepared at the Bachelor of Science in Nursing level or above work on VHWE or HWE units and score higher on seven essential work processes. Nurses’ ratings of quality of patient care directly correlate to quality of work environment. Conclusions Clinical units in 34 Magnet hospitals were markedly skewed toward excellence. Visionary leadership, empowerment and collaboration have an impact on development and maintenance of HWE. Implications for nursing management Implementation of structures that promote interdisciplinary and intradisciplinary collaboration and decision-making positively affect development of HWE. Gap analysis of the steps/components of the eight work processes/relationships essential to HWE may enable achievement of HWEs on all hospital clinical units.     

Nurses' perceptions of hospital work environments

AIM: To examine factors within the nursing work environment that may affect nurse outcomes. BACKGROUND: Primary data were acquired from unit managers and staff nurses on the study units. Secondary data were collected from health records administrative databases. The sample included adult medical and surgical units within all 19 teaching hospitals in Ontario, Canada. METHODS: A cross-sectional study design was employed in this study. A random sampling process was used to recruit the number of nurses (n = 1,116) required to provide a statistically adequate sample for the survey. RESULTS: Perceptions of the quality of care at the unit level were found to have a statistically significant positive influence on nurses' job satisfaction, and a statistically significant negative influence on nurses' job pressure and job threat. CONCLUSIONS: The results of this study underscore the importance of examining the environment in which nurses' work as a potential factor that influences outcomes experienced by patients and nurses.     

临床护士付出-获得不平衡与留职意愿的相关性研究

目的调查临床护士付出-获得不平衡与留职意愿之间的相关性。方法采用付出-获得不平衡量表和留职意愿量表对荆州市8所医院589名临床护士进行调查。结果临床护士付出-获得不平衡比值为1.41,处于付出-获得不平衡状态的护士占69.78%,超负荷状态的护士占73.01%;留职意愿得分为(3.82±0.75)分;临床护士获得与留职意愿呈正相关,付出、超负荷与留置意愿呈负相关(P0.01)。结论护士付出-获得不平衡状态及超负荷状况突出,留职意愿处于中等水平。丰富护士的获得,平衡其付出-获得状况及减轻超负荷状况能提高护士的留职意愿。     

四川省护士感知的工作环境与工作满意度的相关性研究

[目的]调查四川省护士感知的工作环境和工作满意度现况,为提高护士工作满意度提供干预依据.[方法]采用护理工作环境量表及工作满意度调查表,调查四川省20所二级、三级综合医院1 112名护士.[结果]护士感知的工作环境中“医护合作关系”得分最高,其次为“护士参与医院事务”,“充足的人力和物力”得分最低.护士工作满意度维度中“工作独立性”满意度得分最高,其次为“工作安排”满意度,收入得分最低.工作环境各维度与工作满意度呈正相关（P＜0.05或P＜0.01）;护士在目前医院的工作年限和充足的人力与物力对护士工作满意度具有预测作用（P＜0.05）.[结论]关注护士感知的工作环境对工作满意度的预测作用,并就其影响因素制定干预措施,以期提升护士工作满意度,留任护理人才,提升护理品质.     

Exploring the key predictors of retention in emergency nurses

sawatzky j.v. & enns c.l. (2012) Journal of Nursing Management  20, 696–707 Exploring the key predictors of retention in emergency nurses Aim To explore the factors that predict the retention of nurses working in emergency departments. Background The escalating shortage of nurses is one of the most critical issues facing specialty areas, such as the emergency department. Therefore, it is important to identify the key influencing and intermediary factors that affect emergency department nurses’ intention to leave. Methods As part of a larger study, a cross-sectional survey was completed by 261 registered nurses working in the 12 designated emergency departments within rural, urban community and tertiary hospitals in Manitoba, Canada. Results Twenty-six per cent of the respondents will probably/definitely leave their current emergency department jobs within the next year. Engagement was the key predictor of intention to leave (P < 0.001). Engagement was also associated with job satisfaction, compassion satisfaction, compassion fatigue, and burnout (P < 0.05). In an ordinal least-squares model (R² = 0.44), nursing management, professional practice, collaboration with physicians, staffing resources and shift work emerged as significant influencing factors for engagement. Conclusions Engagement plays a central role in emergency department nurses intention to leave. Addressing the factors that influence engagement may reduce emergency department nurses’ intention to leave. Implications for nursing management This study highlights the value of research-based evidence as the foundation for developing innovative strategies for the retention of emergency department nurses.     

The relationship between nursing leadership and nurses' job satisfaction in Canadian oncology work environments

Background  Current Canadian oncology work environments are challenged by the same workforce statistics as other nursing specialties: nurses are among the most overworked, stressed and sick workers, and more than 8% of the nursing workforce is absent each week due to illness.
Aim  To develop and estimate a theoretical model of work environment factors affecting oncology nurses' job satisfaction.
Methods  The sample consisted of 515 registered nurses working in oncology settings across Canada. The theoretical model was tested as a structural equation model using LISREL 8.54.
Results  The final model fitted the data acceptably ( χ ² = 58.0, d.f. = 44, P  =   0.08). Relational leadership and physician/nurse relationships significantly influenced opportunities for staff development, RN staffing adequacy, nurse autonomy, participation in policy decisions, support for innovative ideas and supervisor support in managing conflict, which in turn increased nurses' job satisfaction.
Conclusions  These findings suggest that relational leadership and positive relationships among nurses, managers and physicians play an important role in quality oncology nursing environments and nurses' job satisfaction.
Implications for nursing management  Oncology nursing work environments can be improved by focusing on modifiable factors such as leadership, staff development and staffing resources, leading to better job satisfaction and hopefully retention of nurses.     

Factors contributing to nurse job satisfaction in the acute hospital setting: a review of recent literature

hayes b, bonner a & pryor j (2010) Journal of Nursing Management 18, 804–814
Factors contributing to nurse job satisfaction in the acute hospital setting: a review of recent literature Aim To explore and discuss from recent literature the common factors contributing to nurse job satisfaction in the acute hospital setting. Background Nursing dissatisfaction is linked to high rates of nurses leaving the profession, poor morale, poor patient outcomes and increased financial expenditure. Understanding factors that contribute to job satisfaction could increase nurse retention. Evaluation A literature search from January 2004 to March 2009 was conducted using the keywords nursing, (dis)satisfaction, job (dis)satisfaction to identify factors contributing to satisfaction for nurses working in acute hospital settings. Key issues This review identified 44 factors in three clusters (intra-, inter- and extra-personal). Job satisfaction for nurses in acute hospitals can be influenced by a combination of any or all of these factors. Important factors included coping strategies, autonomy, co-worker interaction, direct patient care, organizational policies, resource adequacy and educational opportunities. Conclusions Research suggests that job satisfaction is a complex and multifactorial phenomenon. Collaboration between individual nurses, their managers and others is crucial to increase nursing satisfaction with their job. Implications for nursing management Recognition and regular reviewing by nurse managers of factors that contribute to job satisfaction for nurses working in acute care areas is pivotal to the retention of valued staff.     

护士职业价值观、工作满意度、工作绩效的关系研究

目的 采用结构方程模型探讨护士工作满意度在职业价值观与工作绩效间的中介作用.方法 采用横断面现况研究于2018年9月至12月采用便利抽样的方法在陕西省6所医院抽取548名一线在职护士作为研究对象.采用护士职业价值观量表(NPVS-R)、护士工作满意度量表(NJSS)、护理行为六维度量表(6-D)进行研究,并分析其相关性...     

Reliability and validity of an instrument assessing nurses' attitudes about healthy work environments in hospitals

mays m.z., hrabe d.p. & stevens c.j. (2011) Journal of Nursing Management 19, 18–26
Reliability and validity of an instrument assessing nurses' attitudes about healthy work environments in hospitals Aim To examine the psychometric properties of an instrument used to evaluate the work environment of direct care nurses employed in hospital settings. Background Healthy work environments are associated with increased retention and high-quality patient care. Methods Items for the instrument were based on the American Association of Critical Care Nurses’ standards for a healthy work environment. Six items measured the individual’s contribution to the work environment and six measured co-workers’ contributions. Each item was graded on a scale from ‘A = well above average’ to ‘F = failing’. The instrument was administered by nurse leaders to 210 direct care nurses in six hospitals. Results The Cronbach α was 0.75 for the self-rating subscale and 0.89 for the co-workers rating subscale. Administrators rated their co-workers significantly higher [n = 32, mean (M) = 2.69, standard deviation (SD) = 0.63] than direct care nurses rated theirs (n = 209, M = 2.31, SD = 0.83, P = 0.03). Direct care nurses intending to stay in nursing rated co-workers significantly higher (n = 170, M = 2.35, SD = 0.81) than those not intending to stay (n = 22, M = 1.87, SD = 0.81, P = 0.01). Conclusion The instrument is a feasible, reliable and valid method for assessing the work environment. Implications for nursing management The instrument can be used to assess the relationship of the work environment to nurse retention in hospitals.     

护理工作环境在临床护士职业认同与工作满意度之间的中介效应分析

目的探讨护理工作环境在临床护士职业认同感与工作满意度之间的中介作用,为临床护士管理提供依据。方法采用护理工作环境量表、护士职业认同问卷和护士工作满意度评定量表对378名临床护士进行调查,并构建结构方程模型。结果护理工作环境量表总分为(191.60±25.42)分,低于常模(P0.01)。护士职业认同感总分为(90.05±11.42)分。护士工作满意度量表总均分为(2.82±0.36)分,低于常模(P0.01)。相关分析显示工作环境、职业认同感与工作满意度之间均存在不同程度的正相关(P0.01)。结构方程模型显示,职业认同对护理工作满意度有直接效应(λ=0.638,P0.01);职业认同对护理工作环境有直接效应(λ=0.443,P0.01);护理工作环境对护理工作满意度有直接效应(λ=0.516,P0.01),职业认同通过护理工作环境对护理工作满意度有间接效应(λ=0.228,P0.01);护理工作环境、职业认同分别解释护理工作满意度16.24%与13.82%的变异量。结论护理工作环境能影响护理工作满意度,提示医院护理管理者应加强护理工作环境建设,改善工作环境,从而增强临床护士职业认同感,提高护理工作满意度。     

Organization, work and work reactions: a study of the relationship between organizational aspects of nursing and nurses' work characteristics and work reactions

This article describes a quantitative, correlational study of the relationship between organizational aspects (such as the predictability of the care), work characteristics (autonomy and workload) and work reactions (work satisfaction and health complaints) in nursing work. The variables have been measured by questionnaires. Subjects were 155 nurses from nine units in two general hospitals in the Netherlands. Several organizational aspects seem to be correlated with work characteristics and work reactions. Organizational aspects particularly influence work characteristics and play, therefore, a mediating role in the relationship between organizational aspects and work reactions. Job satisfaction is not only correlated with the autonomy, but also with workload. Health complaints appeared to be mainly correlated with the workload. It is concluded that for an improvement of job satisfaction and reduction of health complaints, it is not only necessary to improve autonomy and reduce workload, but also to pay attention to organizational aspects because these may influence the work characteristics.     

Effects of work environments on nurse and patient outcomes

purdy n., laschinger h.k.s., finegan j., kerr m. & olivera f. (2010) Journal of Nursing Management 18, 901–913
Effects of work environments on nurse and patient outcomes Aim To determine the relationship between nurses’ perceptions of their work environment and quality/risk outcomes for patients and nurses in acute care settings. Background Nurses are leaving the profession as a result of high levels of job dissatisfaction arising from current working conditions. To gain organizational support for workplace improvements, evidence is needed to demonstrate the impact of the work environment on patient care. Method A multi-level design was used to collect data from nurses (n = 679) and patients (n = 1005) within 61 medical and surgical units in 21 hospitals in Canada. Results Using multilevel structural equation modelling, the hypothesized model fitted well with the data [χ² = 21.074, d.f. = 10, Comparative Fit Index (CFI) = 0.985, Tucker-Lewis Index (TLI) = 0.921, Root Mean Square Error of Approximation (RMSEA) = 0.041, Standardized Root Mean Square Residual (SRMR) 0.002 (within) and 0.054 (between)]. Empowering workplaces had positive effects on nurse-assessed quality of care and predicted fewer falls and nurse-assessed risks as mediated through group processes. These conditions positively impacted individual psychological empowerment which, in turn, had significant direct effects on empowered behaviour, job satisfaction and care quality. Conclusions Empowered workplaces support positive outcomes for both nurses and patients. Implications for nursing management Managers employing strategies to create more empowered workplaces have the potential to improve nursing teamwork that supports higher quality care, less patient risk and more satisfied nurses.